Delayed Lactogenesis Is Associated with Suboptimal Breastfeeding Practices: A Prospective Cohort Study
Delayed Lactogenesis Is Associated with Suboptimal Breastfeeding Practices: A Prospective Cohort Study
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泌乳延迟与母乳喂养不当有关：一项前瞻性队列研究
DOI：
10.1093/jn/nxz311
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发表时间：
2020-04-01
影响因子：
4.2
通讯作者：
Yang, Nianhong
中科院分区：
文献类型：
--
作者：
Huang, Li;Xu, Shangzhi;Yang, Nianhong
背景：母乳喂养对婴儿和母亲都有许多既定的健康益处。有有限的证据之间的关联延迟lactogenesis和母乳喂养practices.Objective：我们评估了延迟lactogenesis和母乳喂养的做法inwomen发起breastfeed.Design之间的关联：我们使用的数据从一个前瞻性队列研究inWuhan，中国，其中包括孕妇在妊娠8- 16周，并随访到产后。包括单胎活产、开始母乳喂养并提供婴儿喂养信息的妇女。在产后第4天通过面对面访谈评估产妇的泌乳状态。在产后3个月、6个月和12个月通过电话访谈询问母乳喂养实践（完全母乳喂养和/或任何母乳喂养）。Poisson回归和考克斯回归用于确定延迟泌乳与母乳喂养的关系。校正潜在混杂因素后，与及时泌乳相比，延迟泌乳与产后3个月（RR：1.24，95% CI：1.10，1.39）和产后6个月（RR：1.14，95% CI：1.04，1.24）时无法维持完全母乳喂养的风险显著相关。在调整后的模型中，延迟泌乳也与任何母乳喂养的提前终止显著相关（HR：1.15，95% CI：1.01，1.30）。在综合分析中，妊娠期体重增加较高的妇女（体重过轻和正常体重的GWG =16 kg，超重/肥胖的GWG = 15 kg），随后出现泌乳延迟的人，提前结束母乳喂养的风险最高。（校正HR：1.32，95%CI：1.11，1.55）与那些获得较少GWG和经历及时泌乳的人相比。这项研究表明，延迟泌乳与全母乳喂养率低和任何母乳喂养持续时间短有关。应加大努力，促进母乳喂养，以推迟泌乳的妇女为目标。
Background: Breastfeeding has many established health benefits to both babies and mothers. There is limited evidence on the association between delayed lactogenesis and breastfeeding practices.Objective: We assessed the association between delayed lactogenesis and breastfeeding practices inwomen initiating breastfeeding.Design: We used data from a prospective cohort study inWuhan, China, which enrolled pregnantwomen at 8-16weeks of gestation and followed up to postpartum. Womenwere included who had a singleton live birth, initiated breastfeeding, and provided information on infant feeding. Maternal lactogenesis status was assessed by face-to-face interview at day 4 postpartum. Breastfeeding practices (full breastfeeding and/or any breastfeeding) were queried by telephone interview at 3, 6, and 12 mo postpartum. Poisson regression and Cox regression were used to identify the association between delayed lactogenesis and breastfeeding practices.Results: Delayed lactogenesiswas reported by 17.9% of the 2877 participants. After adjusting for potential confounders, when compared with timely lactogenesis, delayed lactogenesis was significantly associated with higher risk of inability to sustain full breastfeeding at 3 mo postpartum (RR: 1.24, 95% CI: 1.10, 1.39) and 6 mo postpartum (RR: 1.14, 95% CI: 1.04, 1.24). Delayed lactogenesis was also significantly associated with early termination of any breastfeeding (HR: 1.15, 95% CI: 1.01, 1.30) in the adjusted model. In a combined analysis, women with higher gestational weight gain (GWG, =16 kg for underweight and normal weight, 15 kg for overweight/obesity) and who subsequently experienced delayed lactogenesis had the highest risk of ending any breastfeeding earlier (adjusted HR: 1.32, 95% CI: 1.11, 1.55) compared with those who gained less GWG and experienced timely lactogenesis.Conclusions: This study shows that delayed lactogenesis was associated with low rate of full breastfeeding and shorter duration of any breastfeeding. Greater efforts to promote breastfeeding should be targeted towards women with delayed lactogenesis.